Stress can take a physical and emotional toll, so be prepared to address it head-on.

Stress is on the rise for a lot of Americans, and more than half of us don’t feel like we’re getting the support we need to handle it. Why are so many people stressing out — and what can they do?

According to a Stress in America survey conducted by the American Psychological Association, 1 out of 5 Americans reports feeling extreme levels of stress and more than a third say that their stress has gone up in the past year. Among the leading causes of stress are money, work, family and health issues. Even children aren’t exempt — a new study from Auburn University and the Catholic University of America looks specifically at stress in kids caused by marital conflicts at home.

Many people think of being stressed “as a normal state of being, even though I would argue it’s not,” said Dr. Lynn Bufka, a licensed clinical psychologist, APA’s assistant executive director for practice research and policy, and a member of APA’s Stress in America team. “We don’t necessarily think about how we can do something differently and address this head-on.”

But it does need to be addressed. Stress can have a very real impact on a variety of body systems, from the cardiovascular system to muscles. “There’s often also a physiological reaction in addition to the mental experience of feeling stressed,” said Bufka. “And that may manifest itself in terms of headaches, or stomachaches, or muscle tension.”

So what should you do? For starters, don’t wait for the stress to get to you. “There’s positive things that we can do,” as Bufka points out, “but when we’re feeling stressed we may not always think of those things, so it’s helpful to have a plan in advance.”

Studies have shown that any kind of exercise, from high-energy activities to yoga, can help. “When you exercise, your body releases endorphins, which are hormones that fight stress,” said Frank Lupin, MS, ATC, PES, a certified athletic trainer and a personal trainer for Coordinated Health in Bethlehem, Pa.

People should also consider what the source of their stress is, and whether or not they feel it’s at a manageable level. “It’s when our ability to cope with stressful events exceeds what we have to offer…or when it starts interfering with our functioning and our ability to work or be a student or be a parent,” said Bufka. “That’s when we really need to think…maybe I might need some additional support from a professional.”

The problem is that more than half of Americans feel that their healthcare provider offers little or no support to manage their stress, according to the Stress in America survey.

“When people receive professional help to manage stress and make healthy behavior changes they do better at achieving their health goals,” says American Psychological Association CEO Norman B. Anderson, PhD. “Unfortunately, our country’s health system often neglects psychological and behavioral factors that are essential to managing stress and chronic diseases.”

In many cases, stress just isn’t covered during a typical patient visit, either because of the briefness of the visit or because it’s focused on a specific patient complaint. Bufka suggests that “patients do themselves a good service by going in knowing the questions they want to ask.”

When a patient does raise stress as an issue, some physicians may simply not feel that they can adequately address it. Doctors also may not recognize that a patient is overly stressed and needs help.

If you can’t identify what’s causing your stress or if it persists and starts interfering with your daily life, then speak to your doctor. Ask them about what treatment options, such as therapy or medication, may be available. If your doctor can’t help, they should be able to refer you to someone who can.